1. Field of the Invention
The present invention relates generally to implantable medical devices and to a method for manufacturing implantable medical devices. These implantable medical devices may also be capable of retaining therapeutic materials and dispensing the therapeutic materials to a desired location of a patient's body. More particularly, the present invention relates to a method for forming the structure of a stent or intravascular or intraductal medical device.
2. General Background and State of the Art
In a typical percutaneous transluminal coronary angioplasty (PTCA) for compressing lesion plaque against the artery wall to dilate the artery lumen, a guiding catheter is percutaneously introduced into the cardiovascular system of a patient through the brachial or femoral arteries and advanced through the vasculature until the distal end is in the ostium. A dilatation catheter having a balloon on the distal end is introduced through the catheter. The catheter is first advanced into the patient's coronary vasculature until the dilatation balloon is properly positioned across the lesion.
Once in position across the lesion, a flexible, expandable, preformed balloon is inflated to a predetermined size at relatively high pressures to radially compress the atherosclerotic plaque of the lesion against the inside of the artery wall and thereby dilate the lumen of the artery. The balloon is then deflated to a small profile, so that the dilatation catheter can be withdrawn from the patient's vasculature and blood flow resumed through the dilated artery. While this procedure is typical, it is not the only method used in angioplasty.
In angioplasty procedures of the kind referenced above, restenosis of the artery often develops which may require another angioplasty procedure, a surgical bypass operation, or some method of repairing or strengthening the area. To reduce the likelihood of the development of restenosis and strengthen the area, a physician can implant an intravascular prosthesis, typically called a stent, for maintaining vascular patency. In general, stents are small, cylindrical devices whose structure serves to create or maintain an unobstructed opening within a lumen. The stents are typically made of, for example, stainless steel, nitinol, or other materials and are delivered to the target site via a balloon catheter. Although the stents are effective in opening the stenotic lumen, the foreign material and structure of the stents themselves may exacerbate the occurrence of restenosis or thrombosis.
A variety of devices are known in the art for use as stents, including expandable tubular members, in a variety of patterns, that are able to be crimped onto a balloon catheter, and expanded after being positioned intraluminally on the balloon catheter, and that retain their expanded form. Typically, the stent is loaded and crimped onto the balloon portion of the catheter, and advanced to a location inside the artery at the lesion. The stent is then expanded to a larger diameter, by the balloon portion of the catheter, to implant the stent in the artery at the lesion. Typical stents and stent delivery systems are more fully disclosed in U.S. Pat. No. 5,514,154 (Lau et al.), U.S. Pat. No. 5,507,768 (Lau et al.), and U.S. Pat. No. 5,569,295 (Lam et al.).
Stents are commonly designed for long-term implantation within the body lumen. Some stents are designed for non-permanent implantation within the body lumen. By way of example, several stent devices and methods can be found in commonly assigned and common owned U.S. Pat. No. 5,002,560 (Machold et al.), U.S. Pat. No. 5,180,368 (Garrison), and U.S. Pat. No. 5,263,963 (Garrison et al.).
Intravascular or intraductal implantation of a stent generally involves advancing the stent on a balloon catheter or a similar device to the designated vessel/duct site, properly positioning the stent at the vessel/duct site, and deploying the stent by inflating the balloon which then expands the stent radially against the wall of the vessel/duct. Proper positioning of the stent requires precise placement of the stent at the vessel/duct site to be treated. Visualizing the position and expansion of the stent within a vessel/duct area is usually done using a fluoroscopic or x-ray imaging system.
Although PTCA and related procedures aid in alleviating intraluminal constrictions, such constrictions or blockages reoccur in many cases. The cause of these recurring obstructions, termed restenosis, is due to the body's immune system responding to the trauma of the surgical procedure. As a result, the PTCA procedure may need to be repeated to repair the damaged lumen.
In addition to providing physical support to passageways, stents are also used to carry therapeutic substances for local delivery of the substances to the damaged vasculature. For example, anticoagulants, antiplatelets, and cytostatic agents are substances commonly delivered from stents and are used to prevent thrombosis of the coronary lumen, to inhibit development of restenosis, and to reduce post-angioplasty proliferation of the vascular tissue, respectively. The therapeutic substances are typically either impregnated into the stent or carried in a polymer that coats the stent. The therapeutic substances are released from the stent or polymer once it has been implanted in the vessel.
In the past, stents have been manufactured in a variety of manners, including cutting a pattern into a tube that is then finished to form the stent. The pattern can be cut into the tube using various methods known in the art, including using a laser.
Laser cutting of the stent pattern initially utilized lasers such as the conventional Nd:YAG laser, configured either at its fundamental mode and frequency, or where the frequency of the laser light was doubled, tripled, or even quadrupled to give a light beam having a desired characteristic to ensure faster and cleaner cuts.
Recently, lasers other than Nd:YAG lasers have been used, such as solid-state lasers that operate in the short pulse pico-second and femto-second domains. These lasers provide improved cutting accuracy, but cut more slowly than conventional lasers such as the long pulse Nd:YAG laser.
The intensity of the light beam created by either conventional long pulse or short pulse lasers such as pico-second and femto-second lasers has a Gaussian distribution. A laser beam having a Gaussian intensity distribution results in a beam having higher energy intensity at the center of the beam spot, with reduced energy as a function of distance from the center of the beam spot. This results in a tapered cut when the laser beam cuts through a material. In other words, the cut on the topside of the material is wider than the exit of the laser beam through the bottom side of the material.
When a laser having a Gaussian intensity distribution is used to cut a stent strut the resulting tapered edge causes difficulty in achieving overall dimensional stability after electrochemical polishing. The tapered edge shape may also not be ideal in carrying out its function when the stent is implanted in a vessel, as the tapered strut may not be ideal in opposing the vessel wall.
An additional problem with prior art systems that typically have used lasers that generate long laser pulses with durations in the microsecond range is that this type of laser removes material using a mostly thermal process, with some degree of evaporation of tubing material. In contrast, new lasers operate in the range of 10 pico-seconds (10×10−12 seconds) or shorter for stent cutting, and remove material by way of ablation rather than a thermal process.
The thermal process using long laser pulses can result in molten material and slag, which may be redeposited upon the stent surfaces, as well as surrounding surfaces of the cutting equipment. The thermal process of the long pulse laser may also result in production of a heat-affected zone in the stent tubing material. This heat-affected zone, which occurs frequently when the stent tube is cut by the long pulse laser in the presence of certain reactive gases such as oxygen can result in embrittlement of the stent material and thus decreases mechanical performance of the stent material. In contrast, the short pulses of a pico-second or femto-second laser removes material primarily through ablation which results in minimal thermal damage and a reduction in the amount of slag produced during the ablation process.
What has been needed, and heretofore unavailable, is an efficient and cost-effective laser cutting system that provides for improved cutting speeds and cut profiles. The present invention satisfies these, and other needs.